Loading...
25A-081 (5) k'r �c vt A 'y. t Z rN k 4 zz �1 ti - a > o ...y D _ 3 0 Z r' •� Z mG Z > E O � I � Zoning Miscellaneous Additions, Repairs,Alterations,etc. Tel.No.Y/3 -3 G 4 - "4- 1 Alterations x a NORTHAMPTON, MASS. 3f3 ya Additions _ APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location e ��r.��e S # Lot No. _ 2. Uwne:'s name �-Y n n �� �„ �� �/`��rn+� �A., w 14 Address . Builder's name S(f a ff 6 t4'.r=e c^` Address / `i ;I- /4'- Z,1 N /u Zc vr.� �f,/�/•4 _ Mass.Construcuon Supervisor's License No. S 3 J-6 Expiration Date V/c/a .2— _ 4. Addition �1 5. Alteration 6. New Porch to o 7. Is exisung building to be demolished? !� _ 8. Repair after the fire 1-1 9. Garage 12 o No.of cars Size 10. Method of healing 5 e-g m 11. Distance to lot lines o C- A n e- 12. Type of roof p:aA a _ 13. Siding house 14. Estimated cost-// ?-, J-60 Pr i a ow E,),, A 1-1, The undersign `'c drat the above statements are we to the best of his. knowledgeulre �.._. _. .- / Signature of responsible appicant Kemari`kls b�'I�I e r 1t� : i/� t o f' 0'7 t dorm e.✓' t,, t, x / o r Ats c,,,J 2 6 f✓b11a� t tCS � /1 �\ eySsT..�� yv� (/( ( / ( /L f1114,4 / 1l rhts , V\t- :J t : < re- rn wm /os�r ur<r o:a iklo csr r 4c..u�hl/ f, J2 ) 7esA + J �.rDrT,nt I.a .3// 4 ���^ �+p I��/tiLZc� lc �>lh o� �d H /11�G-1G I/1aAI CCcirrn .2#u4 / e a1 Jv✓�! C si�� �O +Oy F a MAR 3 2000 Crz iaf Narfilallip toll 9 ias%achnsctta cn `f DEPARTMENT OF BUILDII\G INSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WOM CER'S COMPENSATION INSURANCE AFFIDAVIT (Lcensee/Perm�ttee) with a principal place of business/residence at: 1 cl I- r,/,14 Ze ,c, /f 124 Ze.,c v-ff ly,4 olo y(phone,~'#) Y/3 3 (sty eet/city/sial_c_/zip) do hereby certify, under the pains and penalties of penury, that (?C) I am an employer providing the following worker's compensation coverage for my employees working on this job: �rAoederl 6 k u13 566X }3J (lIlSU_I2nCC Company) (Polio Number) (Fxpirat>'on Daze) O I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) Qnsuranc_- Company/Policy Numbcr) (Expiration Date) (Name of Contractor) Omsuiance ComDanv/Pobc7-Number) (Expiration Date) (Name of Contractor) (Ins rant Company/Policy Nuinber) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioml shcct ifnoccns y to mchidc mfonnaIIo(, resta;n=-9no to all oo�trndon) ( ) I am a sole proprietor and have no one worldng for me. ( ) I am a home owner performing all the work myself. NOTE:please be awuc that whim homoowncrs who crnploy pc=m to do mxut= �oommutioa or rcpair work on a dwelling of not mom than throo units in which tux homeowner rtmdca or oa the groua}s appurtcnsm thacto are oot gcarnily oo=datd to be employen under tbo wox-eel compcasatim Act(GL 152.sa 1(5)�application by a homcow=for a license or paulit may m6moc the legal elnnu o£an employer under tiro Workcet Coatpomation Act 1 understand that x copy of this rtLtemcol may be forwarded to tho Department of lodwt�cl AxadcvtY Offioo of rn%rsnoo for the covaagc verification and that Lilure to sxurc oovcrngc under scctioa 25A of MOL 152 can[cad to tho impositioa of criminal pcnaltics ooalvaing of a fnc of up to S 1,500.00 and/or of up to ol),c year and civil penalties ia the form of a Stop Work Order and a firm of S100.00 a dly ap,ysst tp� For&p it roar use only j Permit Number Lot tt Si crnuttce e 1� 1 cs 4 ti i It X 4 4z Xly -Fi�1'11-+ I LL S •� I I +/ y 10. Do any signs ebst on the property? YES NO X IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. ThLi= roia= to be t'i11ed in by the Banding Departmant Required Existing Proposed By Zoning Lot size 166 `x 66 ` Frontage 66 Setbacks 300,0 0, 3 0 - side L:_A I R: f o L:Z R: �a - rear L4 i Building height `/ S Bldg Square footage a ®© O s b f4 S,a o,e- %Open Space: (Lot area minus bldg &paved parking) # of -Parking spaces Per Z-tt t.. Tni4 II L f of Loading Docks Fill: vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. D70E: APPLICANT's SIGNATURE NOTE: lasuanoe of a zoning permit does not relieve an applioant's burden to oom wit zoning requirements and obtain all required pn , hm tali q permits from the Board of Health. Conservtmtion Commission. Department of Publio Works and other applionbla permit granting authorities. FILE if m� � 3200o Fi 1 e No. 6fl ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: s t°rs Address: j /y. L c L e rc it 124 Lc u ro 7f Telephone: 2. Owner of Property:Cyh ���'►. //44-rC �,r��� � Address: � I- (f v n 1,'c-1 I e S t Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee 7r Other(explain): 4. Job Location: Parcel Id: Zoning Map# f)04--"19 Parcel# District(s): �66� (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): er u.' l l ns�gll 94" dcr,mc,. 97,10 rr►kt,,s . 27(6 cc/%. f'c� .1 C/ 2xrir ,� 11'.4 aj w _ LJ 11 AXl6 r lotcw A/6 1 L- b1tk . 4-r'c-'( 1 e., T a a 1 J.+F YJ c...l.'n c �c.A 11 t..,M 7. Attached Plans: X Sketch Plan Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO X DON'T KNOT.^! YES IF YES,date issued: — IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document# 9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES,has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ,date issued: (FORM CONTINUES ON OTHER SIDE) File#BP-2000-0761 APPLICANT/CONTACT PERSON Scott Nickerson ADDRESS/PHONE P O Box J (413)367-0171 PROPERTY LOCATION 27 COOLIDGE AVE MAP 25A PARCEL 081 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ZONING FORM FILLED OUT ENCLOSED REQUIRED DATE Fee Paid Building,Permit Filled out Fee Paid , j O Typeof Construction: CONSTRUCT DORMER FOR BATH&CLOSET New Construction Non Structural interior renovations Addition to Existing Accessoa Structure Build_ing Plans Included: Owner/Statement or License 053156 3 sets of Plans/Plot Plan TH LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: __Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Co 'ssion Signature of Building Official Da Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. 27 COOLIDGE AVE BP-2000-0761 GIS#: COMMONWEALTH OF MASSACHUSETTS *''MV.B1ock: 25A-081 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: ADDITION BUILDING PERMIT Permit# BP-2000-0761 Proiect# JS-2000-1417 Est.Cost: $17500.00 Fee: $87.50 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Scott Nickerson 053156 Lot Size(sq. ft.): 6621 .12 Owner: PRINCE LYNN &AARON DANFORTH Zoning: URB Applicant: Scott Nickerson AT. 27 COOLIDGE AVE Applicant Address: Phone: Insurance: P O Box J (413) 367-0171 LAKE PLEASANTMA01347 ISSUED ON:316100 0:00:00 TO PERFORM THE FOLLOWING WORK.CONSTRUCT DORMER FOR BATH & CLOSET POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings IIR,, Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Rough Frame: Gas Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 3/6/00 0:00:00 942 $87.50 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo